COH FINALS

• Nutrition


  The science of food, the nutrients and other substances therein, their action, interaction and balance in relation to health and diseases and the processes by which the organism ingest, digest, absorbs, transports, utilizes, and excretes food substances.
• Proper Nutrition


  Proper nutrition is an important factor in the etiology of several disease conditions. Key recommendations includes balance caloric intake for weight management, reduce consumption of less healthy foods, increase the overall intake of healthier foods and nutrients, and develop healthy eating patterns.
• Macronutrients

  • Carbohydrates
  • Proteins
  • Fats
  • Water
• Micronutrients

  • Vitamins
  • Minerals
• 
  

  Vitamins and minerals don't provide calories but have roles in the prevention of diseases
• Water


  Considered a macronutrient as it needs to be consumed in (relatively) large quantities in order to survive, however it does not provide any energy and therefore has zero calories
• Proteins


  Chain of Amino acids, an essential nutrient contained in every part of the body, next to water, protein is the most plentiful substance in the body. Sources: Meat, fish, poultry, eggs, milk and cheese and some
• Functions of Proteins


  • Growth and Maintenance
  • Regulating body functions
• Desirable contribution of Carbohydrates, Fats and Protein to the Total Dietary Energy

  • Carbohydrates 55% - 70%
  • Fats and fatty acids: Infants 30% - 40%, All others 20 – 30%
  • Proteins 10 – 15%
• Protein-Energy Malnutrition (PEM)


  Pathological condition arising from lack of dietary protein and energy (calories) in varying proportions. Protein deficiency is called Kwashiorkor, energy deficiency is called marasmus. If the two diseases overlap, it is called protein-energy malnutrition or Marasmic Kwashiorkor.
• Carbohydrates


  The major sources of energy in our diet, the only important source of carbohydrates in animals is milk, the principal sources are plant foods: cereal grains, vegetables like potatoes, beets and corn; fruits, nuts and sugar
• Carbohydrate Consumption and its Effects


  Consumption of excessive amount increases blood glucose level and serum insulin, diet of high glycemic index (GI) foods (simple sugar) alter hormonal and metabolic functions of the body, high GI diets have been linked to increased risk of diabetes and heart disease, low GI diets improves glycemic control in person with diabetes, consumption of less than 50-100 grams of carbohydrate per day can lead to ketoacidosis
• Fats or Lipids


  Provide more than twice as much energy as that of carbohydrates at 9 calories per gram, chief storage form of excess energy from food, products of fat digestion are resynthesized into lipids and transported from the blood to tissues where they are needed as source of energy, these lipids are transported in the bloodstream as lipoproteins, raised LDL in blood are a sign of a high heart attack rate whereas raised HDL concentrations are associated with lower risk of heart disease
• Vitamins


  Needed for body processes in the metabolic and genetic functions of the body, they acts as coenzymes and cofactors in numerous metabolic processes and most are directly or indirectly involved in gene expression, grouped according to solubility: Fat soluble and Water Soluble
• Vitamin A


  Retinol is the most bioavailable form and is stored in liver, absorption varies and is affected by dietary factors like digestibility of proteins complexed with carotenoids and the level and type of fat on the diet, poor protein status reduces the metabolism of
• 2 Main Forms of Vitamin A

  • Preformed vitamin A (retinol, retinyl esters) comes from animal products, fortified foods, and vitamin supplements
  • Provitamin A carotenoids (beta-carotene) carotenoids are found naturally in plant foods, other types of carotenoids found in food that are not converted to vitamin A but have health-promoting properties: Lycopene, Lutein, and Zeaxanthin
• Sources of Vitamin A


  • Green leafy vegetables (kale, spinach, broccoli), orange and yellow vegetables (carrots, sweet potatoes, pumpkin and other winter squash, summer squash)
  • Tomatoes
  • Red bell pepper
  • Cantaloupe, mango
  • Beef liver
  • Fish oils
  • Milk
  • Eggs
• Vitamin A Deficiency


  Xeropthalmia attributable to severe deficiency, most common cause of blindness among young children includes dryness of the epithelial structure of the eye and keratomalacia, night blindness can be common
• Bitot's Spots


  A specific manifestation of Vitamin A deficiency, they are triangular dry, whitish, foamy appearing lesions which are located more commonly on the temporal side, they mainly composed of keratin admixture with gas-forming bacteria Corynebacterium xerosis, lead to foamy appearance.
• Vitamin D

  Responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects in humans, the most important compounds in this group are vitamin D₃ and vitamin D₂. Considered a prohormone.
• Vitamin A Deficiency


  Xeropthalmia attributable to severe deficiency, most common cause of blindness among young children includes dryness or xerosis of the epithelial structure of the eye and keratomalacia night blindness can be common
• Bitot's spots


  • Triangular dry, whitish, foamy appearing lesions which are located more commonly on the temporal side, mainly composed of keratin admixture with gas-forming bacteria Corynebacterium xerosis, lead to foamy appearance
• Vitamin D


  • Responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects in humans, the most important compounds in this group are vitamin D₃ and vitamin D₂
  • Considered a prohormone: Prohormones generally help in amplifying the effect of existing hormones
• Sources of Vitamin D


  • Cod liver oil
  • Salmon
  • Swordfish
  • Tuna fish
  • Orange juice fortified with vitamin D
  • Dairy and plant milks fortified with vitamin D
  • Sardines
  • Beef liver
  • Sun exposure
• Functions of Vitamin D


  • Major function is promotion of Calcium and Phosphorus absorption in the body
  • Acts as steroid in a variety of cellular reactions causing changes in membrane permeability to calcium
  • Induces uptake of phosphate and magnesium in the intestinal brush border
• Vitamin D Deficiency


  • Causes Rickets in kids and Osteomalacia in adult
  • Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency, rickets causes a child's bones to become soft and weak, which can lead to bone deformities, the signs and symptoms of rickets can include: pain – the bones affected by rickets can be sore and painful, so the child may be reluctant to walk or may tire easily; the child's walk may look different (waddling)
• Management of Vitamin D deficiency

  Vitamin D, 400 IU orally is adequate to prevent deficiency in individuals with minimal sun exposure
• Vitamin E


  Stored in muscles, fat, and liver tissues protects the liposome and the mitochondria from free radical damage, has antioxidant activity: improve steroid hormone synthesis and spermatogenesis, this activity is aided by Vitamin C and Selenium
• Sources of Vitamin E


  • Wheat germ oil
  • Sunflower, safflower, and soybean oil
  • Sunflower seeds
  • Almonds
  • Peanuts, peanut butter
  • Beet greens, collard greens, spinach
  • Pumpkin
  • Red bell pepper
• Deficiency of Vitamin E


  Almost never a consequence of a dietary insufficiency, but of chronic cholestasis and pancreatic insufficiency seen associated with other conditions associated with malabsorption like celiac disease, cystic fibrosis, Crohn's disease, and biliary atresia can cause nerve and muscle damage that results in loss of feeling in the arms and legs, loss of body movement control, muscle weakness, and vision problems, another sign of deficiency is a weakened immune system
• Management of Vitamin E Deficiency


  Supplementation with Vitamin E, 600 IU twice daily, raises plasma concentration to normal with cholestatic liver disease, larger oral doses or intramuscular administration may be required because of malabsorption, take this medicine by mouth with a glass of water
• Vitamin K


  Vitamin K refers to structurally similar, fat-soluble vitamins found in foods and marketed as dietary supplements, the human body requires vitamin K for post-synthesis modification of certain proteins that are required for blood coagulation or for controlling binding of calcium in bones
• Sources of Vitamin K


  • Phylloquinone - found in green leafy vegetables including collard and turnip greens, kale, spinach, broccoli, Brussels sprouts, cabbage, lettuces, soybean, canola oil, and salad dressings
  • Menaquinones - found in natto (fermented soybeans) and smaller amounts in meat, cheese, eggs
• Deficiency of Vitamin K

  Hemorrhagic Disease of the Newborn also known as Vitamin K deficiency Bleeding (VKDB) common among breastfed rather than in formula-fed infants, infants of mothers taking drugs that inhibit Vitamin K are at risk of early VKDB and should receive 1 mg IM vitamin K as soon as possible after birth, in exclusively breastfed infants, single IM administration at birth is also effective in preventing late VKBD
• Vitamin C


  An antioxidant required for the synthesis of collagen, a protein substance that forms the base of all connective tissues in the body - bones, teeth, skin and tendons, protect the body from free-radical damage and is involved in the maintenance of chorioamniotic membrane, maintains immune system, help preventing viral or bacterial infections and promote Iron absorption
• Deficiency of Vitamin C


  Scurvy is a state of dietary deficiency of vitamin C (ascorbic acid), the human body lacks the ability to synthesize and make vitamin C and therefore depends on exogenous dietary sources to meet vitamin C needs, the body's pool of vitamin C can be depleted in 1-3 months, Symptoms: anemia, myalgia, bone pain, swelling or edema, petechiae, corkscrew hairs, gum disease and loss of teeth, poor wound healing, and shortness of breath
• Management of Scurvy

  Oral supplementation of 300 mg daily in divided doses of ascorbic acid for at least one month or until body stores are replenished, as indicated by serum levels
• Vitamin B1 (Thiamine)


  Present in all natural foods from either unrefined cereal grains or starchy roots and tubers, helps the body generate energy from nutrients, is necessary for the growth, development and function of cells, most people get enough thiamin from the food they eat
• Deficiency of Thiamin


  Thiamine deficiency affects the CNS, PNS, and the cardiovascular system, Neurologic disorders includes: beri-beri, Wernickes Encephalopathy, and Korsakoff syndrome
• Wet Beri-beri


  Affects the Cardiovascular system, progressive dyspnea and edema after several years of progressive weakness, PE: high-output cardiac failure, wide pulse pressure, tachycardia, enlarged heart, vasodilation and pulmonary congestion, responds to intramuscular doses of 25 mg thiamine followed by 10mg per orem 3x a day